Mediation of the association between maternal pre-pregnancy overweight/obesity and childhood overweight/obesity by birth anthropometry

Mexican Clinical Practice Guidelines for Adult Overweight and Obesity Management

PURPOSE

To develop Mexico's first methodologically rigorous clinical practice guideline for the management of adult overweight and obesity. The target audiences are interdisciplinary healthcare professionals across healthcare systems who are the first point of contact for patients with obesity in Mexico, patients, and health system decision makers.

RECENT FINDINGS

A review of recent international obesity clinical practice guidelines and an expert consensus process identified: i) common recommendations appropriate for implementation in Mexico and ii) knowledge gaps requiring the formulation of new recommendations. In all, 20 new recommendations and 20 good practice statements were developed using the GRADE Evidence-to-Decision Framework and expert consensus. Overweight and obesity negatively impact the health and well-being of individuals and populations in Mexico. This guideline aims to establish a new evidence-based, patient-centered, non-stigmatizing, and practical treatment and management framework, based on the fundamental principles of chronic disease prevention and management.

Maternal Pre-Pregnancy BMI, Offspring Adiposity in Late Childhood, and Age of Weaning: A Causal Mediation Analysis

Infant feeding practices have been hypothesized to influence offspring's body mass index (BMI) later in life, and women with overweight or obesity tend to wean their infants earlier than women with healthy BMI. We, therefore, aimed to investigate how much early age of weaning mediated the maternal-offspring adiposity relationship. The study included 4920 mother-child pairs from the Avon Longitudinal Study of Parents and Children birth cohort. G-computation was applied to estimate the natural direct (NDE) and indirect (NIE) effects, via the age of weaning (<3 months, 3 months, >3 months), of maternal pre-pregnancy overweight or obesity on offspring's BMI and fat mass index. The NDE of maternal overweight or obesity on offspring BMI at 17 years old was 2.63 kg/m2 (95% CI: 2.27 to 2.99). The NIE via the age of weaning was 0.02 kg/m2 (95% CI: 0.00 to 0.04), corresponding to 0.8% of the total effect. Similar results were observed for the offspring's fat mass index. The NDE and NIE were similar to the main analyses when we looked at the relationship stratified by breastfeeding status. Our study found a minimal influence of age of weaning on the pathway between maternal and offspring adiposity, indicating the age of weaning may not be a key mediator.

Predictors of excess body weight concurrently affecting mother-child pairs: a 6 year follow-up

BACKGROUND

We examined the predictors of excess body weight (EBW) concurrently affecting mother-child pairs after delivery during 6 years of follow-up.

METHODS

Prospective cohort study conducted on 435 mother-child pairs. Data were collected at four time points: at birth in the maternity hospital; 1-2 years old, 4-5 years old and 6 years old at the participant's home. Poisson regression analysis was used to examine the predictors of maternal-child EBW: mothers with excessive gestational weight gain (GWG) and large-for-gestational age (LGA) baby (>90th percentile) at baseline and mothers with body mass index (BMI) ≥ 25 kg/m2 and a child > 85th percentile.

RESULTS

The adjusted analysis showed that the risk of mother-child pairs concurrently having EBW increased with increasing pre-pregnancy BMI (RR = 2.4 and RR = 3.3 for pre-pregnancy BMI 25-30 and ≥30 kg/m2, respectively, P < 0.01). Excessive GWG and LGA infants were also significant predictors of EBW concurrently affecting mother-child pairs (RR = 2.2 and RR = 2.3, respectively, P < 0.01).

CONCLUSION

Excessive pre-pregnancy BMI, excessive GWG and LGA status were strong predictors of EBW concurrently affecting mother-child pairs over 6 years of follow-up. Public policies must be established primarily before/during pregnancy to avoid an EBW cycle in the same family over the years.

Mother's education and nutritional status as correlates of child stunting, wasting, underweight, and overweight in Nigeria: Evidence from 2018 Demographic and Health Survey

Aim: This study examined the nexus between mother's education and nutritional status and their relationships with child stunting, wasting, underweight, and overweight. Methods: The data of 34,193 under-five (U-5) children from the 2018 Nigeria Demographic and Health Survey (NDHS) were analyzed using descriptive statistics, and binary and complementary log-logistic regression models. Results: The prevalence of child stunting, wasting, underweight, and overweight were 36.51%, 6.92%, 21.73%, and 2.05%, respectively. Compared to children born to mothers with at least secondary education, uneducated women's children (odds ratio (OR) = 1.55; 95% confidence interval (CI) = 1.32-1.82) and those of women with primary education (OR = 1.49; 95% CI = 1.28-1.72) were more likely to be stunted. Similarly, children born to uneducated women (OR = 1.51; 95% CI = 1.24-1.83) were more likely to be underweight than women with at least secondary education. The likelihood of child underweight (OR = 1.71; 95% CI = 1.45-2.01) and wasting (rate ratio (RR) = 1.82; 95% CI = 1.47-2.26) were higher among underweight mothers, respectively, than those with normal body mass index (BMI). The likelihood of child stunting (OR = 0.75; 95% CI = 0.67-0.84) and underweight (OR = 0.66; 95% CI = 0.57-0.77) were lower among obese/overweight mothers compared to those with normal BMI, but their children were more likely to be overweight (RR = 1.77; 95% CI = 1.27-2.48). Conclusion: Attainment of higher education by mothers should be promoted to prevent childhood nutritional imbalances, and sensitization on healthy dietary habits and lifestyles should be promoted among women, especially the overweight/obese, to reduce their risk of having overweight children.

Cord blood metabolites and rapid postnatal growth as multiple mediators in the prenatal propensity to childhood overweight

BACKGROUND

The mechanisms underlying childhood overweight and obesity are poorly known. Here, we investigated the direct and indirect effects of different prenatal exposures on offspring rapid postnatal growth and overweight in childhood, mediated through cord blood metabolites. Additionally, rapid postnatal growth was considered a potential mediator on childhood overweight, alone and sequentially to each metabolite.

METHODS

Within four European birth-cohorts (N = 375 mother-child dyads), information on seven prenatal exposures (maternal education, pre-pregnancy BMI, weight gain and tobacco smoke during pregnancy, age at delivery, parity, and child gestational age), selected as obesogenic according to a-priori knowledge, was collected. Cord blood levels of 31 metabolites, associated with rapid postnatal growth and/or childhood overweight in a previous study, were measured via liquid-chromatography-quadrupole-time-of-flight-mass-spectrometry. Rapid growth at 12 months and childhood overweight (including obesity) between four and eight years were defined with reference to WHO growth charts. Single mediation analysis was performed using the imputation approach and multiple mediation analysis using the extended-imputation approach.

RESULTS

Single mediation suggested that the effect of maternal education, pregnancy weight gain, parity, and gestational age on rapid postnatal growth but not on childhood overweight was partly mediated by seven metabolites, including cholestenone, decenoylcarnitine(C10:1), phosphatidylcholine(C34:3), progesterone and three unidentified metabolites; and the effect of gestational age on childhood overweight was mainly mediated by rapid postnatal growth. Multiple mediation suggested that the effect of gestational age on childhood overweight was mainly mediated by rapid postnatal growth and that the mediating role of the metabolites was marginal.

CONCLUSION

Our findings provide evidence of the involvement of in utero metabolism in the propensity to rapid postnatal growth and of rapid postnatal growth in the propensity to childhood overweight. We did not find evidence supporting a mediating role of the studied metabolites alone between the studied prenatal exposures and the propensity to childhood overweight.

Added sugars mediate the relation between pre-pregnancy BMI and infant rapid weight gain: a preliminary study

BACKGROUND

Parental obesity is linked to offspring obesity, though little research has explored factors that might influence this relationship during the complementary feeding period. This study investigated whether infant intakes of added sugars mediate the relationship between a mother's pre-pregnancy body mass index (BMI) and infant rapid weight gain (defined as upward weight-for-age percentile crossing).

METHODS

This study was of a cross-sectional design. Anthropometrics for 141 mother-infant dyads (mean age [standard deviation]: 32.6 [4.4] year for mothers, 11.9 [1.9] months for infants) were obtained. Data from three 24-h recalls pertaining to the infants' diets were collected and analyzed. Pearson product-moment correlations and multivariable regressions assessed bivariate relationships between pre-pregnancy BMI, infant added sugar intakes and upward weight-for-age percentile crossing. Mediation models evaluated the effects of added sugars and breastfeeding duration.

RESULTS

Pre-pregnancy BMI correlated positively with infants' added sugar intakes (r = 0.230, p = 0.006). Added sugar intakes mediated the impact of pre-pregnancy BMI on upward weight-for-age percentile crossing (indirect effect = 0.007, 95% CI = 0.0001, 0.0197, indirect/total effect ratio = 0.280). Breastfeeding duration also moderated the relationship, with infants who were breastfed for a shorter duration experiencing a greater mediating effect (indirect effect = 0.010, 95% CI = 0.0014, 0.0277, indirect/direct effect ratio = 0.7368).

CONCLUSIONS

Mothers who were overweight or obese prior to pregnancy were significantly more likely to give their infants foods and beverages with added sugars, and this practice was found to mediate the relationship between maternal and infant obesity. Breastfeeding duration moderated the mediating effect of added sugars between pre-pregnancy BMI and infant rapid weight gain.

What Links Maternal Prepregnancy BMI to Early Childhood BMI: A Serial Mediation Analysis

OBJECTIVE

The aim of this study was to explore the potential impact of maternal gestational weight gain (GWG), infant birth weight, and postnatal weight change (ΔWAZ) on the relationship between maternal prepregnancy BMI (ppBMI) and childhood BMI.

METHODS

This retrospective cohort study analyzed a data set from Wuhan, China. The mediation effect of targeted mediators on the association between maternal BMI and childhood BMI at the age of 2 years was analyzed.

RESULTS

In the mediation model comprising maternal GWG, infant birth weight, and the first-6-month ΔWAZ as mediators of the association between ppBMI and children's BMI, the per unit increase in ppBMI resulted in a 0.01-kg/m² increase in children's BMI, through all three mediators. For the model comprising infant birth weight and the first-6-month ΔWAZ as mediators but maternal GWG as a moderator, the indirect effects of the first-6-month ΔWAZ on the relationship between ppBMI and childhood BMI was 0.0018 higher when maternal GWG increased from average values to 1 SD above the average values.

CONCLUSIONS

Maternal GWG, infant birth weight, and the first-6-month ΔWAZ mediated the effects of maternal ppBMI on children's BMI. Interventions targeting these factors can mitigate the risk of childhood obesity.

Anthropometric Development in Children: Possible Changes in Body Mass, Basal Metabolic Rate and Inflammatory Status

(1) Background: Worldwide, public health policies focus on studying dietary patterns and the related anthropometric changes in children. Their aim is to improve the measures meant to reduce global malnutrition rates. Our goal was to study the main changes in the inflammatory status related to anthropometric changes and total daily energy intake. (2) Methods: We tested the study hypothesis by analyzing serum IL-6 and IL-8 levels, cholesterol and triglycerides values, as well as total proteins and creatinine levels, RMR, and food journals in a sample of 160 healthy subjects aged between 6 and 12 years old. (3) Results: IL-6 was correlated with the skinfold values. Changes in the skinfolds were significantly correlated with total proteins and triglycerides. Both weight for age and height for age were related to the skinfold values. Through the BMR measurements, peak carbohydrate metabolism changed significantly based upon IL-6 values, which were significantly correlated with the respiratory coefficient values. Based on the basal metabolic rate, an increased IL-8 ratio was related to the RQ value. (4) Conclusions: Skinfolds have been significantly correlated with IL-6 and IL-8 levels. With changes in body weight, we encountered differences in both serum cholesterol and serum triglycerides values, unlike total proteins and creatinine, which failed to change.